1974, 07-16 Permit App: K5258 MH County of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT / -
GENERAL REQUIREMENTS PERMIT FEE
PERMIT REQUIRED. A land use or structure permit is required by County Resolution to erect a building or structure of any
kind or alter any building or structure already erected, or to change a land use. Construction mast conform with the
Spokane County Building Code and Zoning Ordinance. Construction is subject to inspection.
WATER. Water supply must be approved by the County and State Health Departments. Where work on water connections disturbs
the surface, shoulders or ditches of County Roads, permission must be obtained from the County Engineer's Office.
SEWAGE SYSTEM. Permits are required in all cases by County Resolutions Nos. 45-133 and 47.235.
SET-BACK FROM PROPERTY LINES. In most zones and under most circumstances, a set-back from the front property line, of at
least 25' is required, a 5' side yard, 15' side yard from a flanking street, and a 25' rear yard are required.
STATE HIGHWAYS. Where the structure abuts a State Highway, clearance must be obtained pertaining to set-back and ingress
and egress.
COUNTY ROADS. Work on street right-of-way may not be performed until staked by County Road Department and work must be
performed in accordance with stakes. Points of ingress and egress must be approved by the County Engineer.
MOVING OF BUILDINGS. A permit is required to move an existing building. When a building is moved on a County or State
Highway, clearance must be obtained from the County Engineer and/or State Highway Department.
ACCESSORY BUILDINGS. Accessory buildings (garages, sheds, etc.) require a separate permit.
RESTRICTIVE COVENANTS. Builders should check provisions of covenants or dedications and easements running with the land
which are enforceable through civil action. County Officials can not bring action to enforce covenants or dedications.
APPLICANT FILL IN BELOW THIS LINE
Name of Owner a 1• Address P' /7// - -"7- Phone5›.e./.:573_1V
Architect Address — Phone
Engineer Address __— Phone
Contractor Address Phone
Legal D ription of Property (Give complet de cription fr m deed,sax receipt, etc.►
�� y �� l _ / - ,�z �� - V 5
/Q55a - 9Oo
DESCRIPTION OF WORK: New k Addition Remodel Moving— Bld . Zone Fire Zone 3
Size of Lot )4/O , /"O Sewage System Const.
Fr., Conc., Br., etc.)
X � Total Sq. Ft. / \
Stories Dimensig Valuation �/
Rooms Baths//' Basement Foundation Const. Cerb 012"( -----Chimney Fireplace
(Full, part, none) (Kind) (Number
Heat. System ✓7 Type of Roofing _!' Ext. Finish Int. Wall Finish —
Use of Bldg. • Amo No. of Units L Bedrooms
PLOT PLAN
Draw sketch with dimensions showing: (1) property lines; (2) street or road locations; (3) location of existing and
proposed buildings; (4) distance to property lines and streets; (5) dimensions of buildings; (6) location of sewage sys-
tem and water supply lines.
NORTH State License No.
Ind. Ins. Acct. No.
_ 75
j"\1\
77—
REQUIRED
Plumbing Permit l�
n+ Heating Permit
- Sewage Permit
-I
Plans Received
Plans Checked
Plans Returned
y Plans Picked Up
(4' Plans Mailed
SOUTH
I h eby certify information submitted is correct d there are no other structures located on this roperty except
as show • 7'7�='(l
Owner or Agent Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
�D7O NOT
WRITE
BELOW THIS LINE
/
Your street address will be ' / 1` d l/_ The zone is �y"1
Sewage Permit Number Issued Building Permit 2 ,5't3 Receipt ('(t- /3d Issued --y/7/17
Remarks
Form 523 Bldg. Code
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